Natural Solutions for Bone, Joint & Muscle Support

by Angela Sabarese | March 1, 2022

As the U.S. population ages, bone, joint and muscle issues are becoming more prevalent. Here are some natural solutions and products that practitioners may want to consider for their patients.

Bone, joint and muscle issues plague a significant number of people during their lifetimes, especially as they age. In recent years, these issues have become even more common in the U.S. as the population grows older. According to Kristin Chapman, product manager, Crystal M. Gossard, education specialist, and Dayna Dye, education content writer, Life Extension (Fort Lauderdale, FL), the National Institutes of Arthritis and Musculoskeletal and Skin Diseases stated that back pain, osteoporosis/osteopenia, bursitis and arthritis are issues related to bone, joint and muscle health. As far as bone issues, according to the institutes’ statistics, one in five adults have arthritis, 5.3 million people aged 50 years and older have osteoporosis at the hip, half of all women and one in four men will have osteoporosis related fractures in their lifetime, and 80 percent of Americans experience low back pain in their lifetime.

“Sarcopenia, a loss of muscle mass and strength,” Chapman, Gossard and Dye explained, “is beginning to be identified as a concern. In 2016, the Aging in Motion Coalition worked with the Centers for Disease Control and Prevention (CDC) to create an ICD-10 code (M62.84) for sarcopenia, which had the following effects: made sarcopenia a reportable disease by medical professionals; increased the diagnosis and treatment of sarcopenia by allowing medical professionals to get reimbursed for their screening time; provided a way to collect data on sarcopenia.”

Jacob Teitelbaum, MD (Kona, HI), shared that the major bone health issue is “loss of bone density, or osteoporosis; the major joint issue is arthritis, including wear-and-tear arthritis (osteoarthritis) and autoimmune arthritis (i.e., rheumatoid arthritis); and the major muscle health issue is muscle pain.” He added that muscle pain is the most common cause of pain and also the type of pain most often missed and most poorly treated by MDs.

Osteoporosis, according to NIH (National Institutes of Health) Osteoporosis and Musculoskeletal and Skin Diseases, is “a bone disease that develops when bone mineral density and bone mass decreases, or when the quality or structure of bone changes. This can lead to a decrease in bone strength that can increase the risk of fractures.” Arthritis is a general term for “conditions that cause inflammation (swelling) of the joints and surrounding tissues.”

Despite the prevalence of these bone, joint and muscle issues, there are distinct causes, many of which can be avoided by taking preventative measures.

Causes of Bone, Joint & Muscle Issues

Joseph Scirica, director of marketing, Natural Immunogenics (Sarasota, FL), offered a well-known adage while discussing the causes of bone, joint and muscle issues: “If you don’t use it, you lose it.” He elaborated, “Lack of exercise and sitting at a computer screen or driving a vehicle eight hours a day is a problem today. Alignment issues also contribute to joint problems,” along with many medical conditions that can cause issues.

Indeed, this problem is significant, as Julia Craven, vice president of education and innovation, Enzyme Science (Venice, FL) elaborated, “While there are plenty of issues that impact bone, joint and muscle health, the biggest one is … physical inactivity. The human body is designed to move, but 25 percent of U.S. adults sit for over eight hours a day—and 40 percent are physically inactive, according to CDC research.”

Craven also added that weak muscles and joint discomfort can also be the result of free radical damage and oxidative stress. In addition, “one cause that’s often overlooked is strenuous exercise itself. While the benefits far outweigh any issues, the body burns fuel faster during high-intensity exercise. At the same time, it’s making more free radicals, speeding up the natural oxidation process and impacting the life cycle of cells. Research has shown that over time, this leads to a buildup of molecules that impact joint movement and comfort.” This is especially something to keep in mind for those who are thinking of jumping into a high intensity workout after being sedentary for a long period.

Chapman, Gossard and Dye concurred with Scirica and Craven, adding that “Lack of proper nutrition … obesity, diabetes, chronic inflammation, repetitive movements due to occupation and smoking” can all contribute to these issues. They continued, “Arthritis, osteoporosis and chronic back conditions commonly occur with other chronic conditions, such as diabetes, heart disease and obesity.”

Dr. Jay Wilkins, founder and formulator, Bionox (Greenville, SC) offered additional causes, including “autoimmune diseases, infections, injuries and sometimes medications” for muscle problems, as well as “runners knee and sprains” for joint complications and “genetic” causes for bone problems, which can be impacted by age, sex and occasionally occupation.

These causes, however, can be prevented with a few lifestyle changes.

Natural Solutions for Bone, Joint & Muscle Problems

“Exercise every day, maintain muscle mass by eating enough protein, improve [the] body’s flexibility and complement [the] diet with dietary supplementation targeting every area of health,” advised Scirica. He added that “the correlation between eating more nutritious foods that supply all the vitamins, antioxidants, minerals and the body’s performance is well-known.” However, “modern agricultural practices have led to a decrease of natural trace minerals in our foods and only about 30 to 40 percent of the copper we consume is absorbed, making supplementation critical.” He suggested that copper, along with zinc and iron, should be considered when looking to improve daily wellness.

Chapman, Gossard and Dye concurred, adding that “managing inflammation through essential fatty acid supplementation and limiting proinflammatory foods such as red meat and sugar, and filling in the gaps with vitamin D and K, essential minerals (calcium, magnesium) are also important strategies.”

In agreement, Craven elaborated that “balance also matters when it comes to fitness. Aerobic exercise like running, walking or biking helps boost cardiovascular health and other benefits for mind and body, while weight-bearing exercises like yoga or strength training help maintain and build strong muscles and bones. Properly warming up and cooling down from any workout helps maintain joint health, too.” In addition, she stressed that “recovery from workouts is as important as the activity itself. That means refueling with protein after exercise, drinking plenty of water, not skipping cooldowns and getting enough sleep, since that’s the time the body uses to prepare itself.” Craven also emphasized that physical therapy and lifestyle changes can go a long way in maintaining bone, muscle and joint health, and can be easily paired with supplements like enzymes.

According to Srinivas Jayanthi, scientific liaison, Bio-Tech Pharmacal (Fayetteville, AK), “Nutrients comprised of proteins, minerals such as calcium, phosphorus, magnesium, potassium, strontium and vitamins D and K appear to be the key ingredients for achieving good bone health.” Furthermore, “Products such as L-arginine and branched chain amino acids along with creatines are commonly used for muscle support.”

Dr. Wilkins added that nitric oxide “assists in minimizing bone loss and improves the functionality of muscles. Through nitric oxide, the body is able to deliver nutrients and oxygen to the muscles and bones; this, in turn, protects our bones and boosts bone and muscle recovery time.”

Dr. Teitelbaum suggested the following preventative measures: “for muscle health, a multivitamin high in B vitamins and magnesium is critical, and for arthritis, decreasing inflammation with omega-3s and decreasing autoimmune issues with vitamin D would be most important.” However, “if arthritis is already present, I give a mix of curcumin, boswellia, DLPA and nattokinase. Lastly, for osteopenia, “in addition to magnesium, vitamin D, vitamin K and 500 mg of calcium a day, all of which are helpful but modestly so, I most recommend strontium 580 mg a night.” He stressed that he does not use this in people with a history of blood clots. “There has been media reporting about it increasing the risk of heart disease, but this risk is quite modest, and I find the strontium to be dramatically safer than the osteoporosis medications.” He also stated that bioidentical testosterone and estrogen can be beneficial for osteoporosis/osteopenia.

Trends/State of the Market

“Based on our research, the bone and joint category presents a great opportunity as it recently showed double-digit growth rates,” said Scirica. “This growth is fueled by the obvious aging population in America and the growing health consciousness of younger consumers taking nutritional supplements in their quest to maintain elevated levels of exercise and activity.”

Chapman, Gossard and Dye offered a different take: “Within the categories respectively, joint sales declined by 1 percent during 2020 with glucosamine/chondroitin having the largest decline of 3.7 percent.” They continued, “following in suit, bone sales also dropped by 2.4 percent and are not expected to recover much in the oncoming years. Calcium in particular declined 0.1 percent, while vitamin D products targeting bone health dropped by 19.9 percent, [according to Nutrition Business Journal (NBJ)]. However, despite this, “the bone and joint supplement market is expected to grow 5.8 percent by 2027.”

Chapman, Gossard and Dye also noted that COVID-19 had an impact on the markets, “as consumers had temporarily shifted from focus on managing these health concerns to a heightened awareness for immunity and overall health.” In addition, the pandemic “impacted gyms, forcing closures, and many have had to take fitness to the home and outside. Many of us also have moved out of the office and continue to work from home. The extended hours sitting in front of the computer and at home can contribute to a loss of muscle mass.” All is not lost despite the market decline, however, as “the opportunity exists for reclamation of this space as joint, bone and muscle health are still a health necessity for the population.”

Jolie Root, senior nutritionist, Carlson Labs (Arlington Heights, IL) noted that “we are seeing more interest in the category in younger demographics which might indicate an uptick of weekend warrior type exertion related to muscle and joint issues as people work out more to relieve their feelings of isolation.” In this way, it is possible that the COVID-19 pandemic has had a positive influence on the trajectory of the industry, although it is concerning that the younger population is overexerting itself due to loneliness.

“We are an aging nation,” said Craven. “In 2018, there were 52 million Americans aged 65 and older. By 2060, that number will reach 95 million. At the same time, people are living longer and aging in place. More older adults mean more aging joints, bones and bodies—and more opportunities to help those individuals maintain their well-being and independence.”

Craven also noted that the pandemic impacted the market. “First, it inspired many individuals to consider their health and well-being aside from their immunity. But the pandemic also kept more people at home, reducing their activity levels. As we move through (and hopefully past) this phase, many people will be looking to resume their active lifestyles—but they may find they’ve lost some strength, endurance and flexibility during that break. They’ll turn to natural supplements, like enzymes, for support.”

Dr. Wilkins offered that the latest news regarding the category “is that consumers are realizing that they cannot achieve their health goals, such as aging and mobility, without addressing bone, joint and muscle support.” He concurred with the acknowledgement of the rise of the geriatric population. Furthermore, “other trends include an increase in spinal infections and technological advancements.” The pandemic, he added, has also shifted awareness toward the category, as “Some cases of COVID-19 have the ability to attack [the] body, causing long term effects on bone and joint pain, along with prolonged muscle aches.” Despite the temporary slump in bone, joint and muscle support supplement sales, companies continue to innovate effective natural products for consumers and practitioner patients.

Products for Practitioners to Consider

There are several practitioner products on the market to address bone, joint and muscle health. Natural Immunogenics, for instance, recently launched Sovereign Copper Bio-Active Copper Hydrosol for joint and bone health. “As an essential mineral, copper is a critical component of enzyme activity, affecting many processes throughout the body* including [that it]: supports strong cartilage and flexible tissue, promotes strong hair and nails, builds collagen for skin elasticity, supports healthy cardiovascular function and improves energy and metabolism,” said Scirica. “Copper’s role in connective tissue is linked to the enzyme lysyl oxidase. From a biochemical perspective, copper is a cofactor for the enzyme and a determinant of its activity in connective tissues, which support joint and bone health for elasticity. Copper’s enzymatic activity is critical for the cross-linking of collagen and elastin, making them strong and flexible.”

Scirica offered conclusions of the European Food Safety Authority (EFSA) scientific publication opinion published in their Journal of 2009: “The panel concludes that a cause and effect relationship has been established between the dietary intake of copper and protection of DNA, proteins and lipids from oxidative damage, normal function of the immune system, maintenance of normal connective tissues, normal energy-yielding metabolism, normal function of the nervous system, maintenance of normal skin and hair pigmentation and normal iron transport.”

The company’s Sovereign Copper, according to Scirica, is a “proprietary blend of Copper I and Copper II species of copper and as such, is the sole form of copper in a liquid form available.” Furthermore, “The product’s composition is ultra-pure with copper of a 99.999 percent purity (ultra-pure per IUPAC), pharmaceutical-grade purified water and a hint of pure silver.” The product is manufactured in an NSF-GMP (good manufacturing practice) certified facility using “the most stringent manufacturing standards to ensure ultimate product purity, quality, identity, composition and strength supporting product safety,” Scirica concluded.

Life Extension offers dozens of products for bone, joint and muscle health, according to Chapman, Gossard and Dye. They highlighted the top two offerings in each category. For bone health, one of their top products is Bone Restore Elite, a clinically studied vitamin K2 dose with calcium for bone. They explained that it “has three well-absorbed forms of calcium and all of the other minerals needed by the bones. It also provides significant doses of vitamin D and K2 (1,000 IU and 45 mg), which are needed for calcium absorption.”

Their next bone health supplement is Vitamin D3 125 mcg (5,000 IU), a potent whole-body health nutrient. The product “provides what is considered an optimal dose of vitamin D by many individuals. Vitamin D is essential for healthy bones and numerous other aspects of health. The product is contained in a gelatin soft gel capsule.”

As far as joint health, Life Extension offers AnthroMax Elite, which inhibits inflammation to support joint and cartilage health. According to Chapman, Glossard and Dye, the product “contains white mulberry, cutch tree and Chinese skullcap extracts to manage healthy inflammation. By offering the benefits of all three, Life Extension provides a best-in-class supplement for joint health support and comfortable freedom of movement.” The company’s Fast Acting Relief provides quick relief for discomfort in bones, joints and muscles. “A combination of turmeric, boswellia and black sesame extracts was shown in clinical trials to help relieve the kind of minor discomforts everyone occasionally experiences,” they stated. “Effective by themselves, when combined these extracts provide even more impressive results. The combination quickly promotes comfort in muscle tissue, bones, joints and ligaments by helping to support a healthy inflammatory response and muscle and joint health.”

For muscle health, Life Extension offers Wellness Code Muscle Strength & Restoration Formula, which sustains muscle health and growth. The product “delivers HMB and vitamin D3 to help maintain muscle mass, build strength and support healthy, sustained muscle function,” they said. “HMB is a bioactive metabolite of the branched-chain amino acid leucine that has beneficial effects on muscle mass by helping to preserve the structural integrity of muscles and supporting muscle growth. HMB also supports exercise performance during both resistance and endurance training.” The vitamin also helps inhibit inflammatory factors to support muscle health. The formula is easily mixed with water, a drink mix or a protein shake mix.

Lastly, the company offers Branched Chain Amino Acids, which promote muscle recovery after exercise. “The branched chain amino acids (BCAAs) L-leucine, L-isoleucine and L-valine help to maintain and build muscle strength and endurance, support physical performance and brain function and promote muscle recovery.” Chapman, Gossard and Dye also stressed that BCAA supplementation can benefit anyone—not just strength or endurance athletes. Life Extension has GMP registration from NSF International.

Enzyme Science, shared Craven, offers MyoMend formula to support muscle and joint function. It “contains a high-potency blend of nattokinase and serrapeptase, two proteolytic enzymes that help break down damaged proteins to accelerate tissue repair. The pair also promotes flexible muscles and joint mobility,” she said. “The formula also includes papain found in papaya and bromelain, commonly found in pineapple. This duo, at least in one study, helped facilitate the repairs that naturally need to take place in muscles after a hard workout.”

Craven added that in addition to enzymes, the company included “the bioflavanoid rutin for its antioxidant support. Traditionally, rutin is known for its ability to help strengthen blood vessels and improve circulation.” In addition, Enzyme Science “formulated MyoMend to include an array of vegetarian proteolytic enzymes including bromelain, papain, protease Thera-blend, serrapeptase, nattokinase and antioxidants to support muscle and joint health,” said Craven. “The unique combination of natural ingredients may help achieve targeted goals, whether it be decreasing muscle soreness, speeding recovery after physical activity or supporting joint mobility.

Carlson Labs offers more than two dozen products for bone, joint and muscle support. The company’s product CherryPURE tart cherry, according to Root, “provides the antioxidant power of proanthocyanidins, which help protect the body from free radicals and promote joint and muscle health.” In addition, their Gingever Ginger is an antioxidant that “protects joints from free radical damage, helps us to move freely and easily, and promotes strong, healthy muscles.” CurcuWIN, an enhanced curcumin extract, “supports joint health and flexibility and is produced with UltraSOL technology, making it highly soluble and bioavailable compared with standard curcumin.” Carlson also offers ApresFlex AKBA Boswellia extract, which promotes joint and connective tissue health and is specially designed for optimal absorption, according to Root.

Carlson Labs also offers many omega-3 supplements, which help reduce chronic inflammation, Root stated. “Nutra Support Bone provides 400 mg of calcium per serving, which is essential for healthy bone growth and density. Vitamin D promotes bone health by helping our body absorb calcium.” Magnesium, manganese and boron are important minerals for bone formation and strength as well, she added. The company also offers Enhanced Mobility, “a unique, high-potency blend of four of nature’s most recognized joint health nutrients: boswellia, curcumin, ginger and tart cherry.” In addition, Nutra Support Joint is “a specialized formula that includes glucosamine, chondroitin, MSM sulfer and potassium, which together promote powerful joint nourishment.” All Carlson products are independently third-party tested and quality assured, Root concluded.

Some of the most popular products offered by BTP, according to Jayanthi, are Vitamin D3 (varied strengths), Cal-Citrate, D3-K2, D3-Plus, Strontium, MK-7, Curcumin and Arginine. “Osteo-Tech is a uniquely formulated dietary supplement specific for this category with a combination of minerals, vitamins and other co-factors that promote healthy bones and joints,” said Jayanthi. “All of the current BTP products are only available in hypoallergenic encapsulated form preferred by most consumers limiting their exposure to unwanted excipients and additives.” BTP is an FDA (U.S. Food and Drug Administration) and NSF cGMP registered DS manufacturer with more than 35 years of experience in formulating and manufacturing high-quality products, he concluded. “Every batch of raw materials, in-process and finished products are thoroughly tested by an independent and ISO/IEC 17025:2017 accredited testing laboratory.”

Bionox, according to Dr. Wilkins, specifically offers nitric oxide supplements that are all-natural and offer support for healthy bones, muscles and the heart. The company’s product M3 Ultimate Nitric Oxide Nutrition “uses the l-arginine, l-citrulline method to promote an increase of nitric oxide production. Combining these key ingredients mixed with amino acids and vitamins D3 and K2, M3 Ultimate Nitric Oxide Nutrition is able to promote blood flow. Through promoting blood flow, nitric oxide is able to allow more nutrients and oxygen to be delivered to working muscles,” explained Dr. Wilkins. “Thus, the body can work out longer and more frequently, while improving strength and functionality of muscles and bones.”

Nox3 Greens Ultimate Nitric Oxide Superfood increases nitric oxide production through the nitrate pathway, Dr. Wilkins shared. “With 26 different superfoods, such as arugula and beets, the body uses the nitrates from the superfoods to then convert into nitric oxide. Not only are [users] getting a dose of all natural superfoods, but you are supporting healthy circulation to bones, muscles and joints. Along with support for vitality, digestion and energy for patients to keep their bodies active.”

The company’s latest product, Nox3 Beets Ultimate Nitric Oxide Lozenge, according to Dr. Wilkins, is plant-based and increases nitric oxide intake through nitrates, just like Nox3 Greens. Nox3 Beets promote healthy cellular energy, nitric oxide production and circulatory wellness. Through increasing circulatory wellness, Nox3 Beets is able to get nutrients to the areas of the body that needs it the most.” It also benefits cardiovascular health. Bionox’s products are all-natural, vegan, non-GMO (genetically modified organism) and made in the U.S.

Dr. Teitelbaum shared that a study was just published demonstrating that using a special form of red ginseng (Red Ginseng Energy by EuroMedica) in fibromyalgia showed “a marked decrease in muscle and other pain. In part, this is because the HRG 80 form of Red Ginseng Energy can dramatically improve energy production. In the 60 percent of people with fibromyalgia who benefited in the study, stamina increased an average of about 70 percent.” Dr. Teitelbaum also recommends B vitamins, magnesium, ribose and a host of other nutrients that can help his patients. He stressed, however, the danger of NSAID (nonsteroidal anti-inflammatory drug) arthritis medications such as ibuprofen, which “unnecessarily cause about 50,000 excess U.S. deaths a year.” Clearly, natural solutions offer real results without the dangers that pharmaceuticals often cause.

Advice for Practitioners

As far as advice, Chapman, Gossard and Dye suggested that “Practitioners, regardless of type, should incorporate products into their practice by following the science and only suggest science-based formulations at doses suggested in the research.” In addition, they “should incorporate a detailed intake process to identify the root cause of someone’s bone, joint and muscle health issues. Identify whether it’s due to diet, repetitive movements, nutritional deficiencies, lack of physical activity, overweight/obesity, chronic inflammation, etc. Educate and partner with the patient to build a trusting relationship and work together to develop a treatment strategy. This will improve compliance and patient by-in.” They added that if a patient is healthy, practitioners should focus on preventative strategies to keep them healthy.

Craven noted that “Practitioners should start with diet and lifestyle changes to encourage patients to support bone, muscle and joint health. And, they can also recommend proteolytic enzymes.” She elaborated, “incorporating digestive, therapeutic and systemic enzymes into a practice can benefit practitioners and help them to solve all their patients’ needs. Client satisfaction is key to building a practice, and the fast acting, wide range of effects from the powerful enzymes offered by Enzyme Science can provide almost immediate positive changes for clients.” In addition, she suggested that practitioners help encourage clients to integrate healthy habits like balanced nutrition and regular exercise into their routine.

Dr. Wilkins stated that overall, “all practitioners can include natural products in their daily use or product options. Simply conduct research and find which natural supplements work best for your clients.”

Healthy Take Aways

• One in five adults have arthritis.
• 5.3 million people aged 50 years and older have osteoporosis at the hip.
• Half of all women and one in four men will have osteoporosis related fractures in their lifetime.
• 80 percent of Americans experience low back pain in their lifetime.